Electroporation in veterinary oncology

Cancer treatments in veterinary medicine continue to evolve beyond the established standard therapies of surgery, chemotherapy and radiation therapy. New technologies in cancer therapy include a targeted mechanism to open the cell membrane based on electroporation, driving therapeutic agents, such as chemotherapy (electro-chemotherapy), for local control of cancer, or delivery of gene-based products (electro-gene therapy), directly into the cancer cell to achieve systemic control. This review examines electrochemotherapy and electro-gene therapy in veterinary medicine and considers future directions and applications.

Low immunogenicity in non-small cell lung cancer; do new developments and novel treatments have a role?

Approximately 1.6 million new cases of lung cancer are diagnosed annually (Jemal et al. CA: A Cancer Journal for Clinicians, 61, 69-90, 2011) and it remains the leading cause of cancer-related mortality worldwide. Despite decades of bench and clinical research to attempt to improve outcome for locally advanced, good performance status patients, the 5-year survival remains less than 15 % (Molina et al. 2008). Immune checkpoint inhibitor (ICH) therapies have shown a significant promise in preclinical and clinical trails to date in the treatment of non-small cell lung cancer (NSCLC). The idea of combining these systemic immune therapies with local ablative techniques is one that is gaining momentum. Electrochemotherapy (ECT) is a unique atraumatic local therapy that has had very promising objective response rates and a number of advantages including but not limited to its immunostimulatory effects. ECT in combination with ICHs offers a novel approach for dealing with this difficult disease process.

An evaluation of the performance and optimization of a new wastewater treatment technology: the air suction flow-biofilm reactor

In this laboratory study, a novel wastewater treatment technology, the air suction flow-biofilm reactor (ASF-BR) - a sequencing batch biofilm reactor technology with a passive aeration mechanism - was investigated for its efficiency in removing organic carbon, nitrogen and phosphorus, from high-strength synthetic wastewaters. A laboratory-scale ASF-BR comprising 2 reactors, 350 mm in diameter and 450 mm in height, was investigated over 2 studies (Studies 1 and 2) for a total of 430 days. Study 1 lasted a total of 166 days and involved a 9-step sequence alternating between aeration, anoxic treatment and settlement. The cycle time was 12.1 h and the reactors were operated at a substrate loading rate of 3.60 g filtered chemical oxygen demand (CODf)/m2 media/d, 0.28 g filtered total nitrogen (TNf)/m2 media/d, 0.24 g ammonium-nitrogen (NH4-N)/m2 media/d and 0.07 g ortho-phosphate (PO4-P)/m2 media/d. The average removal rates achieved during Study 1 were 98% CODf, 88% TNf, 97% NH4-N and 35% PO4-P. During Study 2 (264 days), the unit was operated at a loading rate of 2.49 g CODf/m2 media/d, 0.24 g TNf/m2 media/d, 0.20 g NH4-N/m2 media/d and 0.06 PO4-P/m2 media/d. The energy requirement during this study was reduced by modifying the treatment cycle in include fewer pumping cycles. Removal rates in Study 2 averaged 97% CODf, 86% TNf, 99% NH4-N and 76% PO4-P. The excess sludge production of the system was evaluated and detailed analyses of the treatment cycles were carried out. Biomass yields were estimated at 0.09 g SS/g CODf, removed and 0.21 g SS/g CODf, removed for Studies 1 and 2, respectively. Gene analysis showed that the use of a partial vacuum did not affect the growth of ammonia-oxidizing bacteria. The results indicate that the ASF-BR and passive aeration technologies can offer efficient alternatives to existing technologies.

A clinical review of treatment outcomes in glioblastoma multiforme--the validation in a non-trial population of the results of a randomised Phase III clinical trial: has a more radical approach improved survival?

OBJECTIVE

Glioblastoma multiforme (GBM) accounts for up to 60% of all malignant primary brain tumours in adults, occurring in 2-3 cases per 100,000 in Europe and North America. In 2005, a Phase III clinical trial demonstrated a significant improvement in survival over 2, and subsequently 5, years with the addition of concurrent and adjuvant temozolomide (TMZ) to radical radiotherapy (RT). The aim of this study was to investigate if the demonstrated improved survival in the literature translated to clinical practice.

METHODS

This was a retrospective study including all patients with histologically proven GBM diagnosed from 1999 to 2008 and treated with adjuvant RT at our institution. A total of 273 patients were identified. Statistical analysis was carried out using SPSS® v.18 (SPSS, Chicago, IL).

RESULTS

The median survival for the whole group (n=273) over the 10-year period was 7.6 months (95% confidence interval 6.7-8.4 months). Overall, the cumulative probability of survival at 1 and 2 years was 31.5% and 9.4%, respectively. In total, 146 patients received radical RT. 103 patients were treated with radical RT and TMZ and 43 patients received radical RT alone. The median survival for patients receiving radical RT with TMZ was 13.4 months (95% CI 10.9-15.8 months) vs 8.8 months for radical RT alone (95% CI 6.9-10.7 months, p=0.006). 2-year survival figures were 21.2% vs 4.7%, respectively. On multivariate analysis, independent predictors of survival included Karnofsky Performance Status, RT dose, TMZ and extent of surgery. The strongest predictors of poorer outcome based on the hazard ratio were palliative RT, followed by not receiving TMZ chemotherapy, then KPS <90 and a biopsy only surgical approach.

CONCLUSION

This paper demonstrates improved survival outcomes consistent with those published in the literature for the addition of concurrent and adjuvant TMZ to radical RT for the treatment of GBM. Although 63% of patients seen in the clinic were suitable for a combined modality approach, the prognosis for the lower Radiation Therapy Oncology Group classes still remains poor.

Triad of trichomegaly, alopecia and male-pattern hair growth during treatment with erlotinib in non-small-cell lung cancer

INTRODUCTION

Description of the cutaneous side effects of erlotinib.

MATERIALS

Report with images of a single case.

METHODS

Case report and review of the literature.

CONCLUSION

Erlotinib is associated with significant cutaneous toxicity which should be recognised and managed appropriately.

Primary central nervous system lymphoma: An Irish clinical experience

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Background: North American studies have demonstrated an increase in incidence of primary CNS lymphoma in recent decades. To our knowledge there have been no studies analyzing primary CNS lymphoma in the Irish setting. This prompted a review of cases diagnosed at our institution, the larger of two national neurosurgical/neuro-oncology referral centers. Methods: The records of 78 patients diagnosed with primary CNS lymphoma at our institution between January 1999 and October 2008 were reviewed. Patient's age, sex, and time to diagnosis were noted. Histology and radiology was reviewed for cell of origin, CD20 status, and sites of involvement. HIV serology results were available for 23 patients. Results: The median age was 60 (4–78). There was a slight female preponderance (1.1:1]). Median time from hospital presentation to histological diagnosis was 17 days (4–790). 92% (74) of primary CNS lymphomas were B cell and CD20 positive with 8% (4) being T cell. One-third of patients had multifocal brain involvement by lymphoma. 2 of 23 patients tested were HIV positive. Conclusions: In comparison with international published series primary CNS lymphoma in Ireland is diagnosed at an older median age, has a more even sex distribution and a relatively higher incidence of T cell origin. Multifocal tumor involvement was also more frequent than in other series possibly indicating later clinical presentations. There was a much lower incidence of HIV infection in patients who were tested than in similar North American studies. The wide range in time to diagnosis indicates the difficulties associated with diagnosing this uncommon condition.

No significant financial relationships to disclose.